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Exp Clin Endocrinol Diabetes 2009; 117(10): 593-599
DOI: 10.1055/s-0029-1202792
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Comparative Study of Low-dose Pioglitazone or Metformin Treatment in Japanese Diabetic Patients with Metabolic Syndrome

T. Kato1 , Y. Sawai1 , H. Kanayama1 , H. Taguchi1 , T. Terabayashi1 , F. Taki1 , K. Yamada2 , Y. Yamazaki2 , N. Hayakawa3 , A. Suzuki3 , N. Oda3 , N. Katada1 , M. Itoh3
  • 1Department of Internal Medicine, Aichi Koseiren Toyota Kosei Hospital, Aichi, Japan
  • 2Department of Laboratory Examination, Aichi Koseiren Toyota Kosei Hospital, Aichi, Japan
  • 3Division of Endocrinology & Metabolism, Department of Internal Medicine, Fujita Health University School of Medicine, Aichi, Japan
Further Information

Publication History

received 23.07.2008 first decision 04.09.2008

accepted 19.01.2009

Publication Date:
18 November 2009 (online)

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Abstract

The aim of this study was to determine whether a relatively low dose of pioglitazone or metformin was effective in diabetic patients with metabolic syndrome. Fifty diabetic patients with metabolic syndrome were randomly assigned to a low-dose pioglitazone (15 mg/day) treatment group or a low-dose metformin (500 mg/day) treatment group. Drugs were administered for 12 weeks. Systolic and diastolic blood pressure, heart rate, body mass index, triglyceride (TG), HDL and LDL-cholesterol, fasting plasma glucose (FPG), fasting plasma insulin (IRI), postprandial glucose, and HOMA-IR in the 75gOGTT, HbA1c, high-sensitivity CRP (hs-CRP) determined by cervical artery echography, and pulse wave velocity (PWV) were measured before/after 12-week drug administration. Significant decreases in HbA1c and HOMA-IR were noted in the pioglitazone group, along with significant decreases in TG, AST, ALT, blood pressure, hs-CRP and PWV. Significant decreases in HbA1c, HOMA-IR, BMI and waist circumference were noted in the metformin group. The pioglitazone group significantly improved the values for ALT, systolic blood pressure, hs-CRP and PWV compared to the metformin group. However, the metformin group demonstrated significant improvement in BMI compared with the pioglitazone group. Using a low dose regimen, pioglitazone significantly improved blood pressure and hepatic function and may be more effective than metformin to reduce risk factors in Japanese diabetic patients with metabolic syndrome at preventing atherosclerosis.

Key words

metabolic syndrome - metformin - pioglitazone - atherosclerosis

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Correspondence

Prof. M. ItohMD 

Division of Endocrinology and Metabolism

Department of Internal Medicine

Fujita Health University School of Medicine

Toyoake

Aichi 470-1192

Japan

Phone: +81/562/93 92 42

Fax: +81/562/95/18 79

Email: endolabo@fujita-hu.ac.jp

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